My nose is very fat at the tip specifically, what are my options?

Hello and thank you for your question.  The best advice you can receive is from an in-person
consultation.  Adding photographs would be helpful.  Based on your
description, you may benefit from a tip refining rhinoplasty.   Make sure you specifically look at
before and after pictures of real patients who have had this surgery performed
by your surgeon and not just a computer animation system.
The most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Improving the nasal tip to achieve an improved natural appearing cosmetic result is a frequent request of patients wanting nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or a full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (ENT) that you trust and are comfortable with.If you live outside of the United States, the surgeon should ideally be a member of the International Society of Aesthetic Plastic Surgery(ISAPS). You should discuss your concerns with that surgeon in person. 

Robert Singer, MD FACS

La Jolla,California

Nasal tip refinement can be carried out by reducing the nasal tip cartilage, defatting the tip, suturing technique and in some cases tip grafting.  Seek out an opinion from an experienced rhinoplasty surgeon.